Nurse-led safety forums strengthen escalation of care protocols

Editor's Note

A recent article from Cleveland Clinic details the use of confidential staff forums to address barriers to escalating patient care concerns, resulting in greater caregiver engagement and targeted improvements.

Published July 25, the article describes how nursing leaders collaborated with the Cleveland Clinic Alliance for Patient and Caregiver Safety, a federally certified Patient Safety Organization (PSO), to explore whether caregivers felt equipped to identify and communicate changes in patient condition. The initiative used Safe Tables—confidential forums that encourage open discussion of safety issues—to gather qualitative insight. Four open-ended questions guided Safe Table discussions on escalation of care at 15 US hospitals within the system, grouping responses from 241 nurses thematically to inform planning. Feedback highlighted a critical need for clear escalation pathways within units. 

The confidential nature of Safe Tables allowed caregivers to speak candidly, which contributed to what Cleveland Clinic describes as robust participation. Leaders noted that psychological safety likely supported honest feedback, and caregiver engagement scores improved.

More detail is available in the full report, which closes with three recommendations: prioritize timely escalation through protocols and open communication; promote a supportive culture that empowers caregivers to speak up; and embrace leadership vulnerability by actively soliciting feedback from bedside staff.